Search

There are growing concerns about the impact of pollution on maternal and infant health. Despite an extensive correlational literature, observational studies which adopt methods that seek to address potential biases due to unmeasured confounders draw mixed conclusions. Using a population database of births in Northern Ireland (NI) linked to localized geographic information on pollution in mothers' postcodes (zipcodes) of residence during pregnancy, we examine whether prenatal exposure to PM2.5 is associated with a comprehensive range of birth outcomes, including placental health. Overall, we find little evidence that particulate matter is related to infant outcomes at the pollution levels experienced in NI, once we implement a mother fixed effects approach that accounts for time‐invariant factors. This contrasts with strong associations in models that adjust for observed confounders but without fixed effects. While reducing ambient air pollution remains an urgent public health priority globally, our results imply that further improvements in short‐run levels of prenatal PM2.5 exposure in a relatively low‐pollution, higher‐income country context, are unlikely to impact on birth outcomes at the population level. [ABSTRACT FROM AUTHOR]

Economic downturns may have important implications for the educational attainment and human capital accumulation of children. We examine how income losses during the Great Recession were associated with children's educational performance in Ireland, one of the countries most severely affected by the global financial crisis. Using longitudinal data from a nationally representative child cohort study, collected before and after the recession at ages 9 and 13 years, we estimate panel models to examine the impact of income changes on standardized tests. We explore both objective and subjective measures of recession impact, and investigate non‐linearities and effect heterogeneity using quantile regression. While income is strongly associated with educational performance overall, there is little evidence of a short‐run negative impact of income shocks during the Great Recession on children's test scores. [ABSTRACT FROM AUTHOR]

Bifunctional silanes constitute valuable linking agents for attachment of biomolecules at high levels of surface population density through the formation of thioether or disulfide bonds. Three such compounds, 1-((trifluoroacetyl)thio)- 11-(trichlorosilyl)undecane, 1-bromo-11-(trichlorosilyl)undecane, and 1-((bromoacetyl)oxy)- 11-(trichlorosilyl)undecane, are discussed in terms of their surface chemistry on silicon wafers. To examine the electrophilic and nucleophilic generation of sulfur-containing linkages, three new probes, N'-(pentafluorophenyl)iodoacetohydrazide, N'-(pentafluorophenyl)-3-(2-pyridylthio)proprionohydrazide, and N'-(pentafluorophenyl)mercaptoacetohydrazide, are introduced with respect to their reactions with silanized surfaces (studied by X-ray photoelectron spectroscopy). Thiol-functionalized surfaces obtained by silanization act as nucleophiles toward the probes. In air, low yields of conjugation are exhibited which are attributed to the unavailability of thiol groups because of intramolecular disulfide group formation instigated by oxygen or by disulfide exchange with the proprionyl probe. The behavior of electrophilic silanized surfaces toward the mercaptoacetyl-containing probe is governed by the nature of the leaving group and by steric factors.

Objectives: Policy measures to slow the spread of coronavirus disease 2019 (COVID-19), such as curfews and business closures, may have negative effects on mental health. Populations in low- and middle-income countries (LMICs) may be particularly affected due to high rates of poverty and less comprehensive welfare systems, but the evidence is scarce. We evaluated predictors of depression, anxiety, and psychological distress in Uganda, which implemented one of the world's most stringent lockdowns. Methods: We conducted a mobile phone-based cross-sectional survey from December 2020 through April 2021 among individuals aged 18 years or over in Uganda. We measured depression, anxiety, and psychological distress using the Patient Health Questionnaire (PHQ)-2, the Generalized Anxiety Disorder (GAD)-2, and the PHQ-4. We applied linear regression to assess associations between experiences of COVID-19 (including fear of infection, social isolation, income loss, difficulty accessing medical care, school closings, and interactions with police) and PHQ-4 score, adjusted for sociodemographic characteristics. Results: 29.2% of 4066 total participants reported scores indicating moderate psychological distress, and 12.1% reported scores indicating severe distress. Distress was most common among individuals who were female, had lower levels of education, and lived in households with children. Related to COVID-19, PHQ-4 score was significantly associated with difficulty accessing medical care, worries about COVID-19, worries about interactions with police over lockdown measures, and days spent at home. Conclusions: There is an urgent need to address the significant burden of psychological distress associated with COVID-19 and policy responses in LMICs. Pandemic mitigation strategies must consider mental health consequences. [ABSTRACT FROM AUTHOR]

Introduction: HIV testing is a cornerstone of efforts to combat the HIV epidemic, and testing conducted as part of surveillance provides invaluable data on the spread of infection and the effectiveness of campaigns to reduce the transmission of HIV. However, participation in HIV testing can be low, and if respondents systematically select not to be tested because they know or suspect they are HIV positive (and fear disclosure), standard approaches to deal with missing data will fail to remove selection bias. We implemented Heckman-type selection models, which can be used to adjust for missing data that are not missing at random, and established the extent of selection bias in a population-based HIV survey in an HIV hyperendemic community in rural South Africa. Methods: We used data from a population-based HIV survey carried out in 2009 in rural KwaZulu-Natal, South Africa. In this survey, 5565 women (35%) and 2567 men (27%) provided blood for an HIV test. We accounted for missing data using interviewer identity as a selection variable which predicted consent to HIV testing but was unlikely to be independently associated with HIV status. Our approach involved using this selection variable to examine the HIV status of residents who would ordinarily refuse to test, except that they were allocated a persuasive interviewer. Our copula model allows for flexibility when modelling the dependence structure between HIV survey participation and HIV status. Results: For women, our selection model generated an HIV prevalence estimate of 33% (95% CI 27-40) for all people eligible to consent to HIV testing in the survey. This estimate is higher than the estimate of 24% generated when only information from respondents who participated in testing is used in the analysis, and the estimate of 27% when imputation analysis is used to predict missing data on HIV status. For men, we found an HIV prevalence of 25% (95% CI 15-35) using the selection model, compared to 16% among those who participated in testing, and 18% estimated with imputation. We provide new confidence intervals that correct for the fact that the relationship between testing and HIV status is unknown and requires estimation. Conclusions: We confirm the feasibility and value of adopting selection models to account for missing data in population-based HIV surveys and surveillance systems. Elements of survey design, such as interviewer identity, present the opportunity to adopt this approach in routine applications. Where non-participation is high, true confidence intervals are much wider than those generated by standard approaches to dealing with missing data suggest. Keywords: HIV prevalence; non-participation; missing data; selection bias; Heckman-type selection models; demographic surveillance., Introduction Accurate HIV prevalence estimates are important for many reasons, including the ability to assess disease trajectories, risk factors and the consequences of infection. Estimates from representative household surveys and [...]

We examine socioeconomic heterogeneity in children's time use using diary data from two waves of a nationally representative longitudinal cohort study in Ireland. Children from disadvantaged households spend significantly less time reading, doing homework, and engaging in physical exercise and sport than their counterparts, and more time engaging in unstructured play. Though most gaps are relatively small at age 9, they widen considerably by age 13. This pattern is similar for girls and boys. Parental education appears to be a more important factor in family investment decisions about children's time use than household income. Given the important role of extra‐curricular activities in promoting cognitive and non‐cognitive skill development, the systematic differences in children's time use we document in this paper may contribute to cumulative disadvantage and widening skill gaps through adolescence and into adulthood. [ABSTRACT FROM AUTHOR]

Background: Lipoprotein-associated phospholipase A2 (LpPLA2) is an inflammatory marker that has been associated with the presence of vulnerable plaque and increased risk of cardiovascular (CV) events.Objective: To assess the effect of extended-release niacin (ERN) on Lp-PLA2 activity and clinical outcomes.Methods: We performed a post hoc analysis in 3196 AIM-HIGH patients with established CV disease and low baseline levels of high-density lipoprotein cholesterol (HDL-C) who were randomized to ERN versus placebo on a background of simvastatin therapy (with or without ezetimibe) to assess the association between baseline Lp-PLA2 activity and the rate of the composite primary end point (CV death, myocardial infarction, stroke, hospitalization for unstable angina, and symptom-driven revascularization).Results: Participants randomized to ERN, but not those randomized to placebo, experienced a significant 8.9% decrease in LpPLA2. In univariate analysis, the highest quartile of LpPLA2 activity (>208 nmol/min/mL, Q4) was associated with higher event rates compared to the lower quartiles in the placebo group (log rank P = .032), but not in the ERN treated participants (log rank P = .718). However, in multivariate analysis, adjusting for sex, diabetes, baseline LDL-C, HDL-C, and triglycerides, there was no significant difference in outcomes between the highest Lp-PLA2 activity quartile versus the lower quartiles in both the placebo and the ERN groups.Conclusion: Among participants with stable CV disease on optimal medical therapy, elevated Lp-PLA2 was associated with higher CV events; however, addition of ERN mitigates this effect. This association in the placebo group was attenuated after multivariable adjustment, which suggests that Lp-PLA2 does not improve risk assessment beyond traditional risk factors. [ABSTRACT FROM AUTHOR]